If My Dog Has Canine Intervertebral Disc Disease, Will He Become Paralyzed?
Pain, nerve damage, and paralysis: four words most pet owners hope never to hear.
While not all cases of intervertebral disc disease will end in paralysis, it is one of those conditions where early diagnosis and prompt treatment will result in the best long-term prognosis.
Dr. Cathy Alinovi, veterinarian and owner of Healthy Pawsibilities, author and proud pet parent shares what she has learned about intervertebral disc disease from her clientele.
Question 1: What is intervertebral disc disease (IVDD)?
Dr. Cathy: Between each vertebral bone is a shock-absorbing cushion called a disc. The disc is made of a thick fibrous outside and a soft squishy inside, which is a lot like a cream filled snack cake. The cake is thick like gristle; the cream filling is soft and cushy.
In IVDD, there is damage to the outer ring that allows the cushy inside to leak out. When the inside comes out, it can damage the spinal cord, either because of bruising or taking up space. Regardless, the true problem is actually from spinal cord damage. The symptoms the dog experiences will depend on what part of the spinal cord was damaged.
Question 2: What are the causes of intervertebral disc disease?
Dr. Cathy: Normal, healthy movement moves the vertebrae, which brings blood flow to the disc and keeps it round and supple. In IVDD, there is a weakness of the muscles of the back so the disc is not naturally lubricated. Without the proper movement and lubrication, the rings around the disc become weak (degenerate); weak enough to break and to cause the pulp from the inside to come out either in an explosion or a leak.
Question 3: How many types of IVDD are there?
Dr. Cathy: There are three types of IVDD. They are called Hansen Type I, II, and a non-degenerative type. Type I and II are different kinds of degeneration of the disc.
Type I happens in young chondrodystrophoid dogs. A chondrodystrophoid dog is one that has defective development of the cartilage around the disc, along with the more obvious short legs in relationship with their body size. Type I IVDD is an extrusion/explosion of the pulp out of the disc.
The Type II IVDD is a bulge – a protrusion – and happens more likely in older dogs and non-chondrodystrophoid dogs. The non-degenerative type of IVDD happens because of vigorous exercise or trauma; the spinal cord is bruised but no material remains in the spinal canal.
Q4: Are there breeds with a predisposition to IVDD?
Dr. Cathy: Yes, there are. Please refer to the tables below for a list of the chondrodystrophoid breeds and the non-chondrodystrophoid breeds prone to IVDD.
Chondrodystrophoid Breeds Prone to IVDD
Corgi (Cardigan and Pembroke)
Dandie Dinmont Terrier
Non-chondrodystrophoid Breeds Prone to IVDD
Q5: What symptoms point to a dog with IVDD?
Dr. Cathy: Some warning signs can be hard to pinpoint but might include:
- Difficulty going to the bathroom
- Dragging all four feet
- Dragging one or both back feet
- Inability to raise the tail
- Strange walk
In reality, there are many different symptoms depending on where the disc is.
If the damage from the disc is straight up into the spinal canal, both sides of the body will be affected. If the disc damage is to one side of the spinal cord, only one side of the body will be affected.
Understanding Underwater Treadmill Exercise
Q6: How do vets diagnose IVDD?
Dr. Cathy: A diagnosis is based on a combination of clinical signs and testing. Palpation on the back can show where there are areas of pain. Checking nerve function on each of the legs really helps identify a problem.
X-rays can show where older disc injuries have occurred as well as show areas where the bones are closer together, which suggests the disc is no longer there. An MRI is the gold standard test – it can show if there is something (disc material) in the spinal canal pushing on the spinal cord. In the case of a non-degenerative disc, there will not be any material in the spinal canal; the only evidence on MRI might be a little swelling in the spinal cord.
The downside of an MRI (other than cost) is it does not tell you if the problem area is recent or older; recent implies causing an issue, older implies an incidental finding, which may not be causing problems.
Q7: How can pet owners prevent intervertebral disc disease?
Dr. Cathy: Good nutrition and plenty of water to nourish the discs, consistent exercise to keep the back muscles strong, weight management as extra weight puts strain on the back and discs, and chiropractic (veterinary spinal manipulation therapy) to keep good balance in the back.
Q8: What treatment options are available for dogs with IVDD?
Dr. Cathy: Treatment options range from medical to surgical depending on severity of the disease. Medical treatment is with anti-inflammatories. There are excellent studies in humans that show alternative treatments like chiropractic and acupuncture can be more effective than surgery at taking care of pain and regaining function. These are discussed below.
Q9: If my dog has IVDD, will he need surgical intervention?
Dr. Cathy: Surgery is not the go-to treatment for disc disease. Usually, the only dogs that undergo surgery are the ones who have lost the ability to feel when their bone is pinched (a measure of deep pain). For these dogs, the sooner they go to surgery, the better their chances of recovery. Other dogs that undergo surgery are ones that have repeated bouts of pain – although most of these dogs are not cured by surgery.
Q10: If so, what types of surgical intervention are available?
Dr. Cathy: Surgery removes a part of the vertebral bone so that the disc material that is in the canal pressing on the spinal cord can be removed. The location of the disc rupture determines the type of surgery. For example, the neck is usually accessed from the underside, but the rest of the vertebrae are usually fixed from the back. Recovery from surgery takes days and careful rehabilitation but is similar to the rest of the treatments described here.
Q11: What are the options for medical therapy?
Dr. Cathy: The goal of medical therapy is to get swelling out of the spinal cord as fast as possible. There are many different medications to use, and controversy over which is better. The controversy is really over whether or not to use steroids.
Recently, veterinarians have avoided using steroids for pain relievers. Most non-steroidal anti-inflammatories do not reduce swelling in the spinal cord. For the best chance of recovery, the faster you can get the swelling out the spinal cord, the better, and steroids remove fluid from the cord quickly. Muscle relaxants are also used to treat the spasm that comes with disc pain.
Medical therapy also includes herbal medication and rehabilitation. The great thing about herbal treatment is it can be used with any Western medication and can help to reduce swelling and pain. There are several different herbal formulas to help with pain and swelling. The choice of which formula to prescribe depends on the presenting symptoms of the dog with IVDD. Some names include Di Gu Pi, Double P II, and Dok’s Formula.
Another great thing about herbal medications is they can be used long-term with fewer side effects. Which medication to use will change as the patient’s needs change – that is the great thing about alternative medicine – it changes as the patient changes. Rehab will be discussed below.
Q12: Will my dog need a wheelchair?
Dr. Cathy: For those dogs that have a complete loss of function, a wheelchair is a great tool. Most dogs do great with wheelchairs; there are only a few that reject it.
If your dog does need a wheelchair, make sure you have one custom built to fit your dog properly. It’s like owning a great pair of shoes; they make your feet feel good. The same theory holds true for your dog. A perfectly fitted wheelchair is fun and makes your dog feel free and feel good.
Q13: Will my dog require physical rehabilitation therapy?
Dr. Cathy: Physical rehabilitation (rehab) is a great way to help dogs recover from their injury. The goal of rehab is to strengthen the muscles of the spine around the weak/degenerated disc so the weakness doesn’t cause another disc problem. Without rehab, the chance of recurrence is greater.
Q14: If so, what are the options for therapy?
Dr. Cathy: The different rehab tools include:
- Animal chiropractic
- Therapeutic laser
- Underwater treadmill
Acupuncture is a wonderful tool to reduce swelling and decrease pain. There are numerous studies that prove electroacupuncture (where the needles are connected to low-level electro-stimulation) helps the body release its own natural pain relievers (for example, beta-endorphins), and can work as well, or better, than conventional medicine.
Animal chiropractic, which is called veterinary spinal manipulation therapy, restores balance in the body by restoring motion. In the case of IVDD, there is pain where the disc ruptured (herniated); the body attempts to protect itself from further damage so prevents motion at the spot where the disc ruptured.
Lack of movement leads to muscle spasms; those muscle spasms make the back hurt worse. It becomes a vicious cycle. Chiropractic, combined with other treatment methods, which reduce pain and swelling, when the time is right, restores motion and allows healing.
Massage is a great tool to complement every other treatment method. Massage relaxes muscles and directly blocks pain at the spinal cord. Some patients may be really sensitive to touch at the beginning. Starting with warm and/or cool towels, you can build up to increasing pressure and give your dog some pain relief at home.
Swimming is a great way to exercise without the strain of gravity. It can help restore function and give dogs and the family a great feeling when they see their dog moving. The underwater treadmill helps dogs walk against resistance – think of it as halfway between walking and swimming.
Therapeutic laser (either Class III or IV) reduces swelling and is completely non-invasive. Therapeutic laser is a great way to start treatment without actually touching the dog because it reduces swelling and is completely pain free.
Underwater treadmills help rebuild strength once motion is returned using all the prior tools. Walking underwater against resistance rebuilds muscle and works best when joints are restored to motion and pain and swelling are controlled with medication, laser and any other treatment needed.
Underwater Treadmill Therapy
Q15: How often does IVDD recur?
Dr. Cathy: If nothing is done to stabilize the weak back such as chiropractic or rehabilitation therapy, IVDD can easily recur.
Q16: What level of quality of life will my dog enjoy?
Dr. Cathy: As long as the pain is controlled, your dog will have a great quality of life. Unlike humans, dogs simply figure out the next way of getting done what they need; they do not worry about the things they can no longer do.
Q17: What type of nursing care will I need to provide my pet?
Dr. Cathy: It depends on whether your dog has functional loss, and the level of your dog’s lost abilities. Many dogs have complete return to normal function. Some dogs have a residual limp. Some dogs need a bit more help, for example, a wheelchair or expressing (squeezing) their bladder. Once your dog is over the initial recovery period where a lot of the heavier nursing care is provided in the hospital, you’ll have the more routine care to provide at home.
Q18: What other tips can you share with pet owners of dogs with IVDD?
Dr. Cathy: Numerous studies funded by the National Institutes of Health have shown acupuncture and chiropractic to be superior to surgery for treating pain and improving function. The sooner you seek all out all the options for your dog with disc disease, the better his chances will be. As long as your dog can still feel pain, this is one place where jumping into alternative care will be in your dog’s best interest.
One other important thing: conventional wisdom says that when a dog hurts its back (its disc), the dog must be on cage rest for six weeks. However, consider what sitting in a cage does to your dog.
Movement prevents pain, directly at the spinal cord; thus, sitting in a cage can increase pain. While the objective is not to make the problem worse, sitting in a cage is not making it better.
Dogs with disc problems should have restricted exercise, but still need to move because controlled muscle movement improves healing. Very careful, restricted movement will help your dog heal better than sitting in a cage; excessive movement will also make things worse. Work carefully with your integrative veterinarian to provide the right amount of movement for your healing dog.
© 2014 Donna Cosmato